<?php
/* @var $this SocialHistoryController */
/* @var $model SocialHistory */
/* @var $form CActiveForm */
?>

<div class="wide form">

<?php $form=$this->beginWidget('CActiveForm', array(
	'action'=>Yii::app()->createUrl($this->route),
	'method'=>'get',
)); ?>

	<div class="row">
		<?php echo $form->label($model,'id'); ?>
		<?php echo $form->textField($model,'id'); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'drive'); ?>
		<?php echo $form->textField($model,'drive',array('size'=>5,'maxlength'=>5)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'tobacco'); ?>
		<?php echo $form->textField($model,'tobacco',array('size'=>5,'maxlength'=>5)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'illegal_drug'); ?>
		<?php echo $form->textField($model,'illegal_drug',array('size'=>5,'maxlength'=>5)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'tobacco_type'); ?>
		<?php echo $form->textField($model,'tobacco_type',array('size'=>60,'maxlength'=>300)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'tobacco_ammount'); ?>
		<?php echo $form->textField($model,'tobacco_ammount',array('size'=>60,'maxlength'=>100)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'tobacco_long'); ?>
		<?php echo $form->textField($model,'tobacco_long',array('size'=>60,'maxlength'=>100)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'drug_type'); ?>
		<?php echo $form->textField($model,'drug_type',array('size'=>60,'maxlength'=>300)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'drug_ammount'); ?>
		<?php echo $form->textField($model,'drug_ammount',array('size'=>60,'maxlength'=>100)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'drug_long'); ?>
		<?php echo $form->textField($model,'drug_long',array('size'=>60,'maxlength'=>100)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'gonorrhea'); ?>
		<?php echo $form->textField($model,'gonorrhea',array('size'=>5,'maxlength'=>5)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'hepatitis'); ?>
		<?php echo $form->textField($model,'hepatitis',array('size'=>5,'maxlength'=>5)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'syphills'); ?>
		<?php echo $form->textField($model,'syphills',array('size'=>5,'maxlength'=>5)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'hiv'); ?>
		<?php echo $form->textField($model,'hiv',array('size'=>5,'maxlength'=>5)); ?>
	</div>

	<div class="row">
		<?php echo $form->label($model,'personalinfo_id'); ?>
		<?php echo $form->textField($model,'personalinfo_id'); ?>
	</div>

	<div class="row buttons">
		<?php echo CHtml::submitButton('Search'); ?>
	</div>

<?php $this->endWidget(); ?>

</div><!-- search-form -->